Indian Journal of Endocrine Surgery and Research

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VOLUME 18 , ISSUE 2 ( July-December, 2023 ) > List of Articles


Is Lactation Really a Contraindication or an Unjustified Worry for Milk Fistula in Patients Undergoing Endoscopic Thyroidectomy via Breast Approach

Kamal Kataria, Richa Garg, Vikram Saini, Pritam Yadav, Shahid Dar, Preetham Chiramshetty, Sugandha Agarwal, Kanika Sachdeva, Rajendra Meena

Keywords : Endoscopic thyroidectomy, Lactation, Milk fistula

Citation Information : Kataria K, Garg R, Saini V, Yadav P, Dar S, Chiramshetty P, Agarwal S, Sachdeva K, Meena R. Is Lactation Really a Contraindication or an Unjustified Worry for Milk Fistula in Patients Undergoing Endoscopic Thyroidectomy via Breast Approach. 2023; 18 (2):86-87.

DOI: 10.5005/jp-journals-10088-11225

License: CC BY-NC 4.0

Published Online: 12-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Endoscopic thyroidectomy either by ipsilateral axillo-breast approach (IABA) or bilateral axillo-breast approach (BABA) has gained popularity as a minimally invasive technique, offering high cosmetic satisfaction and noninferiority to conventional thyroidectomy. In literature, lactation has been considered a relative contraindication of endoscopic thyroidectomy via breast approach due to fear of milk fistula formation. Milk fistula, an abnormal connection between a lactiferous duct and the skin, is a complication of radiologic and surgical procedures performed on the lactating breast. While the incidence of milk fistula remains relatively low, its impact on postoperative recovery, patient discomfort, and potential for infection necessitates proactive measures. Hence, a question arises whether lactation should be considered a contraindication for this approach of thyroidectomy. In our setup, We performed six cases of endoscopic thyroidectomy via breast approach in lactating females. Our study cohort had lactating females during 7–12 months of lactation and patients were followed up for a period of 3 months. None of them developed a milk fistula. The lower incidence reported in our study even after periareolar incision may arise from the fact that the plane of dissection was in subcutaneous space, thereby minimum alteration of breast anatomy was done. Although our experience is small but with this experience, endoscopic thyroidectomy seems a safe and feasible option. Larger evidence can be generated once we start using breast approaches in lactating female for endoscopic thyroidectomy.

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